TY - JOUR
T1 - Sex differences in susceptibility to etiologic factors for peripheral atherosclerosis
T2 - Importance of plasma fibrinogen and blood viscosity
AU - Fowkes, F. G. R.
AU - Pell, J. P.
AU - Donnan, P. T.
AU - Housley, E.
AU - Lowe, G. D. O.
AU - Riemersma, R. A.
AU - Prescott, R. J.
PY - 1994/6
Y1 - 1994/6
N2 - Cardiovascular risk factors in men, such as cigarette smoking, hypercholesterolemia, and hypertension, also increase risk in women, but the relative susceptibility to risk factors between the sexes is not established. Our aim was to investigate a wide range of possible etiologic factors in a single population study and identify those that were more strongly related to peripheral atherosclerosis in men or women. We studied personal factors (age and social class), lifestyle factors (smoking, exercise, alcohol intake, and dietary nutrients), and intermediary factors (obesity, diabetes, serum lipids, coagulation, and rheological factors). In the Edinburgh Artery Study in 1988 we measured cardiovascular risk factors in a random population sample of 1592 men and women aged 55 to 74 years. The ankle-brachial pressure index (ABPI), which is inversely related to the degree of peripheral atherosclerosis, was assessed in each subject. Lifetime cigarette smoking was correlated with a lower ABPI equally in men and women (r=-.27, P<.001). Dietary nutrients and alcohol intake were not related differently between the sexes with ABPI. However, recall of strenuous and moderate leisure time exercise during the age range of 35 to 45 years was related more strongly to a higher ABPI in men than in women (P<.05). Plasma fibrinogen, plasma viscosity, and blood viscosity were the only intermediary factors that had stronger univariate correlations with lower ABPI in men than in women. On multivariate analysis, the sex differences persisted for plasma fibrinogen (P<.05) and blood viscosity (P<.001); high-density lipoprotein cholesterol was related to ABPI in men only (sex difference, P<.1). We conclude that most lifestyle and intermediary factors were not related differently in men and women to peripheral atherosclerosis, but elevations in plasma fibrinogen and blood viscosity were each associated with a greater risk of disease in men.
AB - Cardiovascular risk factors in men, such as cigarette smoking, hypercholesterolemia, and hypertension, also increase risk in women, but the relative susceptibility to risk factors between the sexes is not established. Our aim was to investigate a wide range of possible etiologic factors in a single population study and identify those that were more strongly related to peripheral atherosclerosis in men or women. We studied personal factors (age and social class), lifestyle factors (smoking, exercise, alcohol intake, and dietary nutrients), and intermediary factors (obesity, diabetes, serum lipids, coagulation, and rheological factors). In the Edinburgh Artery Study in 1988 we measured cardiovascular risk factors in a random population sample of 1592 men and women aged 55 to 74 years. The ankle-brachial pressure index (ABPI), which is inversely related to the degree of peripheral atherosclerosis, was assessed in each subject. Lifetime cigarette smoking was correlated with a lower ABPI equally in men and women (r=-.27, P<.001). Dietary nutrients and alcohol intake were not related differently between the sexes with ABPI. However, recall of strenuous and moderate leisure time exercise during the age range of 35 to 45 years was related more strongly to a higher ABPI in men than in women (P<.05). Plasma fibrinogen, plasma viscosity, and blood viscosity were the only intermediary factors that had stronger univariate correlations with lower ABPI in men than in women. On multivariate analysis, the sex differences persisted for plasma fibrinogen (P<.05) and blood viscosity (P<.001); high-density lipoprotein cholesterol was related to ABPI in men only (sex difference, P<.1). We conclude that most lifestyle and intermediary factors were not related differently in men and women to peripheral atherosclerosis, but elevations in plasma fibrinogen and blood viscosity were each associated with a greater risk of disease in men.
KW - coagulation
KW - epidemiology
KW - gender
KW - peripheral atherosclerosis
KW - risk factors
KW - viscosity
UR - http://www.scopus.com/inward/record.url?scp=0028321791&partnerID=8YFLogxK
U2 - 10.1161/01.ATV.14.6.862
DO - 10.1161/01.ATV.14.6.862
M3 - Article
C2 - 8199175
AN - SCOPUS:0028321791
SN - 1049-8834
VL - 14
SP - 862
EP - 868
JO - Arteriosclerosis and Thrombosis
JF - Arteriosclerosis and Thrombosis
IS - 6
ER -
